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The addition of adjuvants to local anaesthetics for use in labour epidurals or for intrathecal administration is common practice in obstetric anaesthesia. This chapter provides an overview of the pharmacology of receptors within the epidural and intrathecal spaces and discusses the options available. Adjuncts are classified as opioid and non-opioid and each agent is explored in detail. The mechanism of action, clinical uses, effective dose ranges, speeds of onset and duration, side effects, disadvantages, and special circumstances associated with each agent are explored. Where formal...

The addition of adjuvants to local anaesthetics for use in labour epidurals or for intrathecal administration is common practice in obstetric anaesthesia. This chapter provides an overview of the pharmacology of receptors within the epidural and intrathecal spaces and discusses the options available. Adjuncts are classified as opioid and non-opioid and each agent is explored in detail. The mechanism of action, clinical uses, effective dose ranges, speeds of onset and duration, side effects, disadvantages, and special circumstances associated with each agent are explored. Where formal guidelines exist, these are discussed in detail. Although large randomized controlled trial data is lacking, information regarding current knowledge of the behaviour of these agents in obstetric and non-obstetric practice is presented to assist clinicians when deciding about the appropriateness of each agent for their individual practice.